THE PLACE OF LOCAL, LOW-DOSE, LOW DURATION FIBRINOLYSIS IN THE TREATMENT OF ARTERIAL OCCLUSIONS

551 angiographic therapeutic radiological interventions were studied in detail. They included 246 patients treated by local, low dose fibrinolysis with consecutive PTA, 55 interventions treated by fibrinolysis therapy alone and 250 patients treated by angioplasty. The results of low dose, low duration fibrinolysis with or without consecutive PTA was compared with the "standard" results from PTA despite the variations in the severity of the arterial occlusive disease. The indications for local fibrinolysis are discussed and the variations from the technique reported in the literature are described ("retrograde" local fibrinolysis). We have not been able to show any statistical relationship between clot lysis and duration of history or the length of vascular occlusion. Clinical improvement of at least one stage (according to Fontaine) was achieved in 85% of cases by PTA, 60% by local lysis and 74% by lysis with subsequent PTA.